Provider Demographics
NPI:1447898713
Name:WEST COAST SPEECH THERAPY
Entity type:Organization
Organization Name:WEST COAST SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BA-SLPA
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:174-860-0022
Mailing Address - Street 1:11005 W ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-6898
Mailing Address - Country:US
Mailing Address - Phone:714-860-0022
Mailing Address - Fax:
Practice Address - Street 1:11005 W ADAMS ST
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-6898
Practice Address - Country:US
Practice Address - Phone:714-860-0022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty